胸壁肿瘤切除术后钛合金人工肋骨重建胸壁骨架

Titanium alloy steel artificial rib reconstruction of chest wall after tumor resection

目的 探讨胸壁肿瘤切除术后骨性胸壁缺损不同外科手术重建的效果.方法 1999年3月至2008年8月治疗胸壁肿瘤28例患者,切除肋骨3～6根,肿瘤切除后遗留巨大胸壁缺损,其中21例采用钛合金人工肋骨隔肋重建.胸壁软组织缺损采用转移肌皮瓣（胸大肌肌皮瓣、背阔肌岛状肌皮瓣、腹直肌肌皮瓣）修复.结果 全组无手术死亡病例,术后胸廓稳定性良好,无反常呼吸运动及呼吸困难.并发骨性重建后软组织与修复物之间积液3例,经保守治疗后痊愈.本组随访8～76个月,2例失访,随访率92.9%,4例胸壁良性肿瘤患者术后分别生存7.8、7.2、5.4和3.6年,22例胸壁恶性肿瘤患者术后1、3、5年生存率分别为77.3%（17/22）、63.2%（12/19）和41.2%（7/17）.结论 钛合金人工肋骨重建胸壁骨架是一种简单、有效的方法,可获得良好的临床效果.

Objective To evaluate the effects of chest wall reconstruction after tumor resection patients with chest wall defect. Methods From March 1999 to August 2008,28 patients with chest wall tumor underwent chest wall reconstruction.The number of rib resected was 3-6. Twenty-one huge chest wall defects underwent chest wall reconstruction using titanium alloy steel artificial rib. The materials for the soft tissue reconstruction include latissimus dorsi myocutaneous flap. Results No died of operation, postoperative respiratory function was good, no abnormal breathing exercises. Concurrent osseous tissue repair and rebuilt in 3 cases, the fluid recovered after conservative therapy. Followed-up 8-76 months,2 cases were lost, follow-up rate was 92.9% ,4 cases with benign tumor existed 7.8,7.2,5.4 and 3.6 years, 22 cases with malignant tumor after 1, 3, 5 years survival rate were 77.3% （17/22） ,63.2% （12/19）,41.2% （7/17） respectively. Conclusion A favorable clinical outcome can be achieved by titanium alloy steel artificial rib reconstruction of chest wall.